Biomass smoke exposure as a serious health hazard for women.

INTRODUCTION: Lung diseases caused by biomass exposure cause a significant health hazard particularly amongst women. The present study was designed to investigate biomass exposure in women suffering from lung disease. MATERIALS AND METHODS: A total of 100 women [mean (SD) age: 55.13 (17.65) years] hospitalized for chronic obstructive pulmonary disease (COPD), asthma, bronchiectasis, tuberculosis or interstitial lung disease were included in this study conducted between September 2008-March 2009 in three chest disease clinics at Sureyyapasa Chest Diseases and Chest Surgery Training and Research Hospital. Data collection on biomass exposure was based on application of hospital-based survey questionnaire including items on occupation, level of education, place of birth (location, region), exposure to biomass fuel fumes for heating and cooking purposes (animal dung, wood, charcoal, dried plant) and years of exposure with animal dung, wood, charcoal, dried plant. RESULTS: COPD in 22% patients, lung carcinoma in 12%, bronchitis in 8%, tuberculosis in 26%, and interstitial lung disease in 17% were the diagnosis for hospitalization. The most identified occupation was housewifery 86%. Active, former and non-smokers composed 6%, 22% and 72% of the population. Birth place was village in 67% patients while districts in 9%. According to regional distribution, the most common place of birth was Central Anatolia region in (29%). Exposure to biomass fuels was identified in all of patients including wood (92%), animal dung (30%), charcoal (23%), and dry plant (23%). Mean (SD) years of exposure was identified to be 52.6 (17.9) years for wood, 40.8 (17.9) years for animal dung, 48.1 (20.8) years for dry plant and 38.5 (21.4) years for charcoal. The most common type of biomass exposure was wood in village (97%), city (79%) and county (89%). CONCLUSION: Findings indicating impact of biomass exposure in women seem to emphasize the need for analytic epidemiologic studies assessment measuring biomass exposure levels-particularly for women and young children.

[The influence of community-acquired pneumonia to the clinical course in COPD cases admitted to intensive care unit with acute respiratory failure]. / Yogun bakim ünitesine akut solunum yetmezligi ile kabul edilen KOAH olgularinda pnömoni varliginin klinik seyre etkisi.

In this study the influence of community-acquired pneumonia to the clinical course in 173 COPD patients admitted to ICU with acute respiratory failure (ARF) was evaluated. In prospective descriptive study, patients with pneumonia at admission to ICU were grouped as Group 1, others Group 2. The demographics, "Acute Physiology Assessment and Chronic Health Evaluation (APACHE) II" scores, body mass index (BMI), comorbidities, steroid use, admission arterial blood gases (ABG), leucocyte and CRP, utilization and duration of non-invasive and invasive mechanical ventilation (NIMV and IMV), development of ventilator associated pneumonia (VAP) and septic shock, length of stay (LOS) in ICU and mortality of groups were recorded and compared. No differences were found between demographics, but leucocyte and CRP levels were determined higher in Group 1(p= 005, 0.001). NIMV, IMV ratio and IMV days are similar (respectively p= 0.419, 0.170, 0.459); NIMV was applied longer in Group 2 (p= 0.019). 4 (17.6%) patients in group 1 and 7 (6.3%) patients in Group 2 were switched to IMV(p= 0.083) due to NIMV failure.While VAP was detected in 8 (17.7%) cases of intubated 45 (26%) patients, rate of VAP was similar in both groups (p= 0.657). 2 (6.7%) patients in Group 1 and 12 (8.3%) patients in Group 2 died and no difference was found in terms of LOS in ICU. Mortality was found 3 times higher (26.7%) than overall mortality (8.1%) in patients with IMV. Mortality risk factors are higher CRP levels (p< 0.016, OR: 1.01 CI 95%: 1.00-1.02), NIMV application determined to reduce the mortality. In conclusions, the presence of pneumonia, on admission to ICU in COPD patients with ARF, didn't influence IMV duration, LOS and mortality in ICU. Although mortality can be higher in COPD patients with high CRP levels, but NIMV is thought to be a mortality reducing treatment approach.